Chronic Kidney Diseases in Agricultural Communities

Event Details

Background

There has been a significant increase in the global burden of chronic kidney diseases of uncertain or non-traditional etiologies, primarily in agricultural communities. This condition has variously been referred to as chronic kidney disease of unknown (CKDu) or non-traditional etiology (CKDnt), chronic intersitital nephritis in agricultural communities (CINAC) and Mesoamerican nephropathy (MeN). Although the general presentation of this condition appears to be similar across affected regions, it remains unclear whether this condition represents one common disease or a syndrome of related ones that differ from affected region to region. A number of potential etiologies and pathophysiological mechanisms for this condition have been proposed, but significant debate exists regarding which factor(s) are the most important to the incidence and progression of chronic kidney diseases in these agricultural communities.

Objectives

We plan to bring together clinicians, basic scientists, epidemiologists, and public health officials to discuss the current gaps in knowledge and to develop a coordinated scientific research agenda leading to a better understanding of the causes and potential treatments of chronic kidney diseases in agricultural communities.

Organizing Committee

Kevin Abbott, M.D., M.P.H., Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH

John Balbus, M.D., M.P.H., NIEHS-WHO Collaborating Centre for Environmental Health Sciences, National Institute of Environmental Health Sciences, NIH

Ricardo Correa-Rotter, M.D., Instituto Nacional de Ciencas Medicas y Nutricion Salvador Zubirán (Mexico)

Brian Curwin, Ph.D., National Institute for Occupational Safety and Health, CDC

Denise Gaughan, Sc.D., Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH

Bonnie Joubert, Ph.D., Population Health Branch, National Institute of Environmental Health Sciences, NIH

Paul Kimmel, M.D., Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH

Erik Koritzinsky, Kidney Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH

Ty Lawson, NIEHS-WHO Collaborating Centre for Environmental Health Sciences, National Institute of Environmental Health Sciences, NIH

Adeera Levin, M.D., University of British Columbia (Canada)

Susan Mendley, M.D., Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH

Kathleen Michels, Ph.D., Division of International Research and Training, Fogarty International Center, NIH

Dale Sandler, Ph.D., Epidemiology Branch, National Institute of Environmental Health Sciences, NIH

Carol Shreffler, Ph.D., Exposure, Response, and Technology Branch, National Institute of Environmental Health Sciences, NIH

William Suk, Ph.D., M.P.H., Hazardous Substances Research Branch, National Institute of Environmental Health Sciences, NIH

Brittany Trottier, M.P.H., Hazardous Substances Research Branch, National Institute of Environmental Health Sciences, NIH

Elizabeth Whelan, Ph.D., National Institute for Occupational Safety and Health, CDC

Yining Xie, M.D., Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, NIH

Registration Deadline

June 18, 2018

Agenda

June 25, 2018

8:00 a.m. – 8:10 a.m.

Welcome and Introduction
Robert Star, Director – Division of Kidney, Urologic, and Hematologic Diseases, NIDDK

8:10 a.m. – 8:20 a.m.

Welcome and Introduction
Gwen Collman, Director – Division of Extramural Research and Training, NIEHS

How should we define CKDu?

8:20 a.m. – 8:30 a.m.

What we know (and don’t know) about CKDu in Agricultural Communities in the Americas and worldwide
Shuchi Anand, Stanford University

8:30 a.m. – 8:45 a.m.

Challenges in case definition in low resource settings
Murray Mittleman, Harvard School of Public Health

8:45 a.m. – 9:00 a.m.

How to create an exposure paradigm for a novel disease
Robert Wright, Mount Sinai School of Medicine

9:00 a.m. – 9:30 a.m.

Questions

Using geography to find insights into CKD

9:30 a.m. – 9:40 a.m.

Solving the mystery of Balkan nephropathy
Arthur Grollman, Stony Brook University

9:40 a.m. – 9:50 a.m.

What can the USRDS tell us?
Rajiv Saran, University of Michigan

9:50 a.m. – 10:05 a.m.

Questions

10:05 a.m. – 10:25 a.m.

Break

Investigating the cause of CKDu

10:25 a.m. – 10:35 a.m.

CKDu in Texas
David Sheikh Hamad, Baylor College of Medicine

10:35 a.m. – 10:50 a.m.

Insights into pathogenesis of CKDu from renal biopsies
Marc De Broe, University of Antwerp

10:50 a.m. – 11:15 a.m.

Questions

11:15 a.m. – 12:15 p.m.

Poster session (Posters will be available for viewing for the full duration of the meeting)

12:15 p.m. – 1:15 p.m.

Lunch

1:15 p.m. – 3:15 p.m.

Charge to working groups
Working Groups

1. Creating a Case Definition:
   Ricardo Correa-Rotter (National Medical Science and Nutrition Institute Salvador Zubirán)
   Shuchi Anand (Stanford University), Murray Mittleman (Harvard School of Public Health)
   José Escamilla (Pan American Health Organization)
2. Defining Common Data Elements:
   Liz Amos (National Library of Medicine)
   Madeleine Scammell (Boston University)
   Robert Wright (Mount Sinai School of Medicine)
   Rajiv Saran (University of Michigan)
   Ludovic Reveiz (Pan American Health Organization)
3. Understanding Barriers to Studying Agricultural Workers/Ethics of Conducting a Study:
   Adeera Levin (University of British Columbia)
   Jason Glaser (La Isla Network)
   Diane Rohlman (University of Iowa)
   Carla Saenz (Pan American Health Organization)

 

3:15 p.m. - 3:35 p.m.

Break

3:35 p.m. - 5:10 p.m.

Reports of working groups with discussion and synthesis

5:10 p.m. - 5:20 p.m.

Summary of the day
Kevin Abbott, NIDDK

5:20 p.m. - 6:00 p.m.

Return to Posters

6:00 p.m.

Adjourn

June 26, 2018

8:00 a.m. – 8:10 a.m.

Introduction and Review of Progress Day 1

Studying the Agricultural Environment

8:10 a.m. – 8:20 a.m.

Assessing environmental exposures
Elizabeth Whelan, NIOSH, CDC

8:20 a.m. – 8:30 a.m.

Soil and water analysis
Geoff Plumlee, United States Geological Survey

8:30 a.m. – 8:40 a.m.

Metal exposures and chronic kidney disease
Ana Navas-Acien, Columbia University

8:40 a.m. – 9:10 a.m.

Questions

Gaining Trust in the Community

9:10 a.m. – 9:20 a.m.

Studying the agricultural worker experience in El Salvador
Madeleine Scammell, Boston University

9:20 a.m. – 9:30 a.m.

Studying pesticide exposure in Egyptian agricultural workers
Diane Rohlman, University of Iowa

9:30 a.m. – 9:50 a.m.

Questions

Studying the Entire Population

9:50 a.m. - 10:00 a.m.

The role of genetic susceptibility in CKDu
David Friedman, Beth Israel Deaconess Medical Center

10:00 a.m. - 10:15 a.m.

Epidemiological challenges to studying agricultural communities
Kate Applebaum, George Washington University

10:15 a.m. - 10:45 a.m.

Questions

10:45 a.m. - 11:00 a.m.

Charge to working groups
Break

11:00 a.m. - 12:00 p.m.

Day 2 Working Groups: Approaches to Create a Research Plan
Group A:
Ana Navas-Acien (Columbia University)
Robert Wright (Mount Sinai School of Medicine)
Kate Applebaum (George Washington University)
Group B:
David Sheikh Hamad (Baylor College of Medicine)
Diane Rohlman (University of Iowa)
David Friedman (Beth Israel Deaconess Medical Center)
Group C:
Elizabeth Whelan (NIOSH, CDC)
Murray Mittleman (Harvard School of Public Health)
Arthur Grollman (Stony Brook University)

12:00 p.m. - 1:30 p.m.

Working Lunch

1:30 p.m. - 3:30 p.m.

Reports of working groups with discussion and synthesis

3:30 p.m.

Wrap up

Abstracts

Related Files

Speaker Abstract Packet (PDF, 192.39 KB)

Final Poster Listing (PDF, 161.43 KB)

Mindmap (PDF, 35.9 KB)